The short answer is: it depends on your situation. For ACA Marketplace plans, you generally cannot buy coverage anytime you want. There is a defined open enrollment window each year. Outside that window, you need a qualifying reason. But if you qualify for Medicaid or CHIP, you can enroll any time of year, no waiting required.
Most people searching this question fall into one of three situations: they missed open enrollment, something in their life just changed, or they never had coverage and are figuring out their options. Each situation has a different path forward. This article walks through all of them.
How Open Enrollment Works
The ACA Marketplace has a set open enrollment period each year. For 2026 coverage, that window ran from November 1, 2025 through January 15, 2026 on HealthCare.gov (the federal marketplace). Some states with their own exchanges extended their deadlines into January or February 2026.
If you enrolled by December 15, 2025, your coverage started January 1, 2026. If you enrolled between December 16 and January 15, coverage started February 1, 2026.
Once that window closes, you cannot simply log on and buy a Marketplace plan. You need a specific reason, which is where Special Enrollment Periods come in.
Special Enrollment Periods: The Door That Stays Open
A Special Enrollment Period (SEP) is a 60-day window during which you can enroll in or change a Marketplace health plan outside of open enrollment. The window opens when you experience a qualifying life event.
Qualifying Life Events in 2026
The following events trigger a Special Enrollment Period:
- Losing health coverage. This includes losing coverage from an employer plan, a parent's plan, COBRA running out, or losing Medicaid or CHIP. You generally have 60 days from the date of loss to enroll.
- Getting married or entering a domestic partnership. You and your new spouse can enroll in a plan within 60 days of the marriage.
- Having or adopting a child. A birth, adoption, or placement for foster care opens a 60-day SEP.
- Moving to a new coverage area. If you move to a new state or county where your current plan is not available, you qualify for an SEP.
- Losing dependent status. For example, turning 26 and aging off a parent's plan.
- Gaining citizenship or lawful presence. Newly eligible immigrants can enroll through an SEP.
- A change in income that affects your eligibility for subsidies. If your income drops and you now qualify for premium tax credits when you did not before, that can trigger an SEP in some states.
The SEP window is 60 days from the triggering event in most cases. For job-based coverage loss, you can sometimes act up to 60 days before the expected loss date, which gives you more runway to plan.
What Coverage You Can Get Through an SEP
Through a Special Enrollment Period, you can enroll in any Marketplace plan available in your area: Bronze, Silver, Gold, or Platinum tiers. If your income qualifies, you can also receive premium tax credits and cost-sharing reductions (more on those below).
ACA Subsidies in 2026: What Changed
For 2026, the enhanced premium tax credits that had been in place since the American Rescue Plan expired at the end of 2025. The "subsidy cliff" has returned. That means Marketplace subsidies are now only available to households earning between 100% and 400% of the federal poverty level (FPL).
Here is what those income limits look like for 2026:
| Household Size | 100% FPL (minimum) | 400% FPL (maximum for subsidies) |
|---|
| 1 person | $15,650 | $62,600 |
| 2 people | $21,150 | $84,600 |
| 3 people | $26,650 | $106,600 |
| 4 people | $32,150 | $128,600 |
| 5 people | $37,650 | $150,600 |
| 6 people | $43,150 | $172,600 |
| 7 people | $48,650 | $194,600 |
| 8 people | $54,150 | $216,600 |
| Each additional | +$5,500 | +$22,000 |
Note: These figures use the 2025 FPL guidelines, which apply to 2026 Marketplace coverage. Alaska and Hawaii have higher limits.
Cost-Sharing Reductions (CSRs) are also available if you earn between 100% and 250% FPL and enroll in a Silver plan. CSRs lower your deductibles, copays, and out-of-pocket maximum, which makes the coverage significantly more valuable at that income range.
If your income is above 400% FPL, you can still enroll in a Marketplace plan, you just pay the full premium without subsidy help.
Medicaid and CHIP: No Open Enrollment Required
This is where many people are surprised. Medicaid and CHIP do not have open enrollment periods. If you qualify, you can apply and enroll any day of the year.
Medicaid covers low-income adults, children, pregnant women, and people with disabilities. In states that expanded Medicaid under the ACA, most adults with income up to 138% FPL qualify. That is roughly $21,597 for a single person or $44,367 for a family of four in 2026.
CHIP covers children in families that earn too much for Medicaid but still need help affording coverage. Income limits vary by state but typically extend to 200% to 300% FPL for children.
Because Medicaid and CHIP accept applications on a rolling basis, they are often the right first step if you missed open enrollment and are unsure whether you qualify for anything. If you are eligible, coverage can start very quickly, sometimes within days of approval.
You can apply for Medicaid through your state's Medicaid agency or through HealthCare.gov, which will route your application to the right program if it determines you qualify.
Medicare: Different Rules Entirely
If you are 65 or older, or have a qualifying disability, Medicare has its own enrollment periods that operate completely separately from the ACA Marketplace.
- Initial Enrollment Period (IEP): A 7-month window centered on your 65th birthday (3 months before, your birthday month, and 3 months after).
- General Enrollment Period (GEP): January 1 through March 31 each year, for those who missed their IEP. Coverage starts July 1.
- Special Enrollment Period: Available if you have employer coverage through an active job when you turn 65. You can delay Medicare without penalty and enroll when that employer coverage ends.
Medicare and Marketplace plans operate as separate systems. If you are eligible for Medicare, you generally cannot use Marketplace subsidies.
Visit /medicare-eligibility for a full breakdown of Medicare eligibility pathways and enrollment windows.
Short-Term Health Plans: A Caution
If you missed open enrollment and do not qualify for an SEP, some people turn to short-term health plans. These plans are available year-round in most states and tend to have lower premiums.
The trade-off is significant. Short-term plans are not ACA-compliant. They can:
- Deny coverage based on pre-existing conditions
- Exclude essential health benefits like prescription drugs or mental health care
- Cap how much they pay out in total
- Leave you with large bills they will not cover
Some states (California, New York, Massachusetts, and others) have banned or heavily restricted short-term plans. Before considering one, understand exactly what it covers and what it does not.
Health care sharing ministries are another alternative some people explore, but they are not insurance and provide no legal protections or coverage guarantees.
What to Do Right Now
If you are outside of open enrollment and unsure of your options, work through these steps:
- Check if you qualify for Medicaid or CHIP. This is the fastest path to coverage if your income is low enough. There is no deadline. Apply today.
- Check if you had a qualifying life event in the last 60 days. Job loss, marriage, a new baby, moving, losing other coverage. Any of these opens an SEP.
- Check your income against the subsidy table above. If you are between 100% and 400% FPL, you likely qualify for meaningful financial help with a Marketplace plan, assuming you have an SEP.
- If none of the above apply, start planning now for the next open enrollment period (typically starting November 1 each year for the following year's coverage). In the meantime, look into whether your employer offers coverage, whether you can join a family member's plan, or whether a short-term plan makes sense as a bridge.
The eligibility screener at CoveredUSA can help you figure out which programs you qualify for in about two minutes. It asks for your household size, income, state, and a few other basics, then tells you which programs are likely a match.
Employer Coverage: A Separate Track
None of the above applies if you have access to employer-sponsored insurance. Employer plans have their own open enrollment periods, typically in the fall for January 1 coverage. If you lose employer coverage mid-year (for example, you leave a job), you have 60 days to sign up for a Marketplace plan through an SEP or to sign up for COBRA to continue your employer plan at your own cost.
COBRA lets you keep your existing employer plan, but you pay the full premium, including the portion your employer used to cover. It is often expensive but can be worth it for a few months while you find another option.
Frequently Asked Questions
Can I buy health insurance at any time of year?
Not through the ACA Marketplace. Open enrollment runs once a year (November 1 through January 15 on HealthCare.gov for most states). Outside of that window, you need a qualifying life event to trigger a Special Enrollment Period. The exceptions are Medicaid and CHIP, which accept applications year-round with no open enrollment requirement.
What happens if I miss open enrollment and have no qualifying event?
Your options narrow. You can apply for Medicaid if your income is low enough. You can look at short-term health plans, though they have significant coverage gaps and are banned in some states. You can go without coverage until the next open enrollment, which starts November 1. Going uninsured carries financial risk, so it is worth calling a licensed broker to review your situation.
How long do I have after a qualifying life event to enroll?
Usually 60 days from the date of the triggering event. For anticipated coverage loss (like a job ending on a known date), you can sometimes act up to 60 days before. Do not wait, because missing the 60-day window means starting over at the next open enrollment.
Does losing a job qualify me for a Special Enrollment Period?
Yes, if losing your job means losing health coverage. Job loss that triggers a loss of employer-sponsored insurance is one of the most common SEP qualifying events. You have 60 days from the date you lose coverage to enroll in a Marketplace plan.
What income qualifies for ACA subsidies in 2026?
For 2026, subsidies are available to households earning between 100% and 400% of the federal poverty level. For a single person, that is roughly $15,650 to $62,600. For a family of four, it is roughly $32,150 to $128,600. Note that the enhanced subsidies that were available in 2024 and 2025 have expired for 2026.
Can I get Medicaid right now even though open enrollment is over?
Yes. Medicaid has no open enrollment period. If you meet your state's income and eligibility requirements, you can apply and enroll today. In expansion states, most adults under 138% FPL qualify. Check your state's Medicaid agency or use the screener at CoveredUSA to confirm eligibility.
What if I have a baby or get married? Can I add them to my plan outside of open enrollment?
Yes. Having a baby, adopting a child, or getting married are all qualifying life events that open a 60-day Special Enrollment Period. You can enroll yourself, your spouse, or your child in a Marketplace plan during that window, or add them to an existing plan.
Is Medicare the same as the ACA Marketplace?
No. Medicare is a federal program for people 65 and older and certain people with disabilities. The ACA Marketplace is for people who do not have Medicare, Medicaid, or affordable employer coverage. They operate under completely different rules and cannot be combined with subsidies in most cases. If you are approaching 65, check your Medicare Initial Enrollment Period timeline to avoid late enrollment penalties.
Check your eligibility now at CoveredUSA, it takes 2 minutes. Use the free screener to find out whether you qualify for Medicaid, CHIP, ACA subsidies, Medicare, or other coverage options based on your income, household size, and state.
